Nebivolol (Oral)

Overview

Nebivolol essentially contains an active ingredient denoted as nebivolol hydrochloride which is a beta-blocker. Beta-blockers, as the name suggests, block beta receptors in various parts of the body. Nebivolol works by blocking beta receptors that prevent the action of two chemicals, noradrenaline and adrenaline, which are naturally synthesized by the body.

Beta receptors are located in the heart. High blood pressure is characterized by the vigorous and rapid pumping of the heart. Nebivolol blocks the action of beta receptors in the heart thus effectuating the slow and gentle pumping of the heart. Ergo, modulating blood pressure.

Nebivolol also broadens and relaxes the blood vessels thus reducing the resistance in blood vessels. All these actions cumulatively effectuate the lowering of blood pressure with the use of Nebivolol. Nebivolol in addition to other medicines may be used to treat chronic, acute heart failure in patients above 70 years of age.

Conditions Treated

  • High blood pressure
  • Heart failure in patients above 70 years old at the discretion of a doctor.

Type Of Medicine

  • Beta-blocker

Side Effects

Along with the intended effects, a drug may have some unwarranted and undesirable consequences. Every drug has side effects that are heavily documented via drug trials and subsequent reports from patients. Not all side effects may occur, and some patients may be spared from the unwanted effects of a drug. In the event you experience any side effect, immediately seek the help of your doctor.

The following is a list of the common side effects associated with Nebivolol. The statistics dictate that these side effects are reported in 1 in 10 patients or 1 in 100 patients who use the drug. If you experience either of the following side effects, promptly seek the advice of your medical practitioner, who prescribed the medicine.

  • Mild headaches
  • Dizziness
  • Diarrhea
  • Constipation
  • Fatigue and tiredness
  • Pins and needles (paraesthesia) in the extremities
  • Shortness of breath (dyspnoea)
  • Swelling (edema) due to the excessive retention of fluid in the body tissues.

In sporadic cases, Nebivolol has pronounced counterproductive effects. Before prescribing any medicine, it is crucial for healthcare providers to weigh the benefits against the handicap of a drug. The catalog below highlights the less common side effects of Nebivolol, that affects up to 1 in 100 patients or 1 in 1000 patients.

  • Bradycardia which is the typified with a sluggish heart rate
  • Aggravation of heart failure
  • Depression
  • Indigestion
  • Vomiting
  • Impotence
  • Rapid weight gain
  • Rash or severe itching
  • Nightmares
  • Fainting
  • Blue finger and toes
  • Visual disruption
  • Flatulence
  • Heart block which is epitomized with problems with the nerves around the heart, specifically the electrical pathways that control the pumping mechanism of the heart.

If your experience any of the following side effects, please consult your doctor for remediation. He may adjust the dosage of your drug or augment the use of Nebivolol with other prescriptions to alleviate the symptoms. Your doctor may also altogether stop the use of Nebivolol once other medical reasons are put into consideration. Do not stop the use of Nebivolol without consulting a doctor. Spontaneous discontinuation of Nebivolol could provoke a heart attack or a stroke.

Some side effects do not require the intervention of your doctor. These side effects are a result of your body trying to acclimatize to the medication. These side effects usually alleviate with time. Those side effects are:

  • A distant or mild headache
  • An acute rash
  • Insomnia having trouble sleeping
  • Diarrhoea
  • Sleeplessness

The treatment of high blood pressure involves the coupling of medications with lifestyle changes. These lifestyle changes are meant to amplify the effect of the drug. These changes include a dietary shift in ingesting wholesome foods with low-fat and low-sodium; regular exercise of at least 30 minutes every other day; and no cigarette smoking and moderate alcohol use.

Some changes can help remediate some of the side effects that patients of Nebivolol have reported. To reduce the risk of lightheadedness and dizziness, slowly get up when ascending from a sitting position. If the side effects continue to become bothersome, inform your doctor promptly.

Nebivolol may reduce the amount of blood flowing to your extremities. To remedy this do not smoke tobacco as smoking aggravates this effect. Dress appropriately and avoid tobacco use.

A severe allergic reaction to Nebivolol is unaccustomed. Notwithstanding, seek medical attention straightaway when you experience the following symptoms synonymous with an allergic reaction to this medicine

  • Rash and itching
  • Severe dizziness
  • Laboured breathing
  • Swelling of the tongue, face, and throat.

Other side effects not listed may occur in some patients. If you notice any changes in the use of Nebivolol, consult your healthcare professional.

Dosage

As it is the axiom of prescription drugs, it is crucial to adhere to the instructions on the use of the drug from a healthcare professional. Both the directions given by your doctor, and the guidelines provided by the manufacturer should govern on how to use a drug.

Guidelines on the frequency and amount of medicine to be taken should be adhered to without fail to not compromise the efficacy of a drug.

The dosage of Nebivolol is variant and depends on the health condition of a patient at the time. A medical practitioner can tweak the dosage of Nebivolol to cater to the medical needs of a patient. The dosage prescribed to a patient depends on the potency of the medicine.

Depending on the medical condition for which Nebivolol is to mitigate, a healthcare professional can tailor the dosage by adjusting the daily dosage, the time span between doses, and the duration of dosage.

Nebivolol often comes in the form of a tablet and is administered orally once a day. To remember to administer Nebivolol, take the pill at the same exact time every day. Nebivolol may be taken with or without food and should be swallowed with a drink of clean water.

The following information only accommodates the average doses of Nebivolol for the treatment of hypertension. If your prescription happens to be divergent, do not change it unless with the authority of a medical practitioner.

For oral dosage form, Nebivolol is available in tablet form. The dosage is as elucidated.

  • For adults initial dosage is a standard 5 milligrams (mg) per day. Your doctor then now gradually increases your dose not more than once every two weeks.
  • For children the use and dose are exclusively determined by your doctor.

The inadvertent missing of a dose is common among all patients. If you happen to miss a dose take it as soon as you remember. If the time for the next dose is fast approaching forgo the missed dose and go back to the regular schedule of administrating the drug. Ensure that you do not double dose by compensating for missed doses. This could lead to an overdose. Read the manufacturer's pamphlet in the packaging to educate yourself on the symptoms of a Nebivolol overdose.

Drug Interactions:

Certain drugs should not be used together as their combination may be lethal or counterproductive. Ergo, it is crucial to inform your doctor of any medicines you are taking, or have been taking, including over the counter drugs and herbal medication, before the commencement of your treatment with Nebivolol.

Nonetheless, two different medicines may be used simultaneously even if an interaction may occur. This warrants your medical professional to adjust your dosage to prevent the occurrence of adverse effects. Vividly, the relying on information to your doctor is pivotal.

Nebivolol is notorious for drug interactions. Over 750 medications are known to interact with nebivolol. The catalog below highlights the medicines that are recommended not to be used in combination with Nebivolol. If the prescription of both drugs is ineluctable, your healthcare provider may adjust the dosage and duration of use of Nebivolol to accommodate the safe biochemical interaction of these two drugs.

Nebivolol, when used with other drugs that lower blood pressure, is likely to have an addictive effect. The drug interaction between two antihypertensives leads to low blood pressure which manifests itself as dizziness. This can be relieved by lying down and letting the dizzy spell pass. Medicines that reduce blood pressure are listed below:

  • Benzodiazepines such as diazepam and temazepam
  • Antipsychotics, for instance, chlorpromazine
  • Alprostadil
  • Aldesleukin
  • ACE inhibitors, for example, enalapril
  • Angiotensin II receptor antagonists such as losartan
  • Alpha-blockers such as prazosin
  • Baclofen
  • Alternative beta-blockers such as propranolol
  • Diuretics such as bendroflumethiazide and furosemide
  • Bromocriptine and apomorphine which are dopamine agonists
  • Methyldopa
  • Minoxidil
  • Moxisylyte
  • Nicorandil
  • Nitrates such as glyceryl trinitrate
  • Diazoxide
  • Tizanidine
  • Levodopa
  • Phenelzine which is an example of MAOI antidepressants.

If nebivolol is taken in combination with calcium channel blockers such as verapamil, diltiazem, and nifedipine, this amplifies the risk of slow heart rate and ultimately heart failure. Verapamil much not be intravenously administered to patients under Nebivolol prescription.

If clonidine is taken in combination with nebivolol to manage hypertension, do not sporadically halt the use of clonidine, as this amplifies the risk of increasing blood pressure. Nebivolol should be stopped several days prior to the gradual discontinuation of clonidine.

The drug interaction between Nebivolol and the listed drugs raises the likelihood of experiencing the risk of fatal heart block and slow heart rate:

  • Diltiazem
  • Verapamil
  • Digoxin
  • Antiarrhythmics, for instance flecainide, amiodarone, and quinidine

Additionally, Nebivolol interacts with medicines used to treat diabetes. Nebivolol reduces the efficacy of diabetes medication by tinkering with the potency of these drugs and consequently decreasing the anticipated blood sugar, lowering the success of these drugs. Diabetes patients should carefully monitor their blood sugar levels when using this drug as nebivolol may hide some of the signs of low blood sugar such as tremors and increased heart rate.

The medications below diminish the blood pressure, reducing effects of nebivolol:

  • Prednisolone and dexamethasone which are corticosteroids
  • Estrogens such as those contained in a contraceptive pill
  • The frequent use of non-steroidal anti-inflammatory drugs (NSAIDs): ibuprofen, indomethacin, and diclofenac

If the secondary derivatives of ergot, such as methysergide and ergotamine are used in combination with nebivolol, there is a risk of numbness, tingling, and coldness of the extremities.

It is prudent to avoid the use of certain medicines around the time of ingesting food or in combination with some foods altogether due to interactions with the drug. Some interactions may cause adverse effects, or aggravate the likelihood and intensity of side effects.

It is advised not to take nebivolol with alcohol and tobacco. The medical treatment of hypertension is augmented with lifestyle changes that require patients to abandon foods high in fat and sodium. Alcohol is high in fats and calories while tobacco intensifies the side effects of nebivolol such as pins and needles on the extremities.

Warnings

Before the commencement of the use of nebivolol is it crucial to inform your healthcare professional of prior and current use of medications that treat the following medical problems as interactions may affect the efficacy of the drugs prescribed to treat these conditions:

  • Cardiogenic shock
  • Heart block or heart failure
  • Lung disease
  • Diabetes
  • Renal disease
  • Liver disease
  • Bradycardia
  • Peripheral vascular disease
  • Angina
  • Hyperthyroidism
  • Hypoglycemia
  • Pheochromocytoma
  • Sick-sinus syndrome

Nebivolol is reported to instigate fatigue and dizziness. Cautions should be taken when engaging in potentially hazardous activities such as driving or operating heavy machinery. It is prudent to establish how Nebivolol affects your body and then making the necessary changes to accommodate this.

Do not sporadically discontinue the use of nebivolol especially if you have ischaemic heart conditions such as angina. The cessation of the administration of nebivolol should be done gradually over an extended period, traditionally, over 1 to 2 weeks.

At all times divulge information to the healthcare provider attending to you, on the use of nebivolol. This is crucial when undergoing minor or major surgery at the hospital or the dentist's office. This is because your blood pressure may fall to fatal levels due to the interaction of nebivolol and certain anesthetics.

Nebivolol is not to be used in the case you are allergic to any of the components contained in the tablet. Please inform your doctor if you have any allergies. Stop the use of the medicine if you experience an allergic reaction and promptly notify a medical professional.

The manufacturers of nebivolol dictate that this medicine should not be taken while pregnant unless it is fervently established that it is necessary. Beta-blockers significantly reduce the flow of blood to the placenta during pregnancy which is essential for development. As such, this could lead to increase in the likelihood of premature delivery or miscarriage. Furthermore, nebivolol may slow the baby's heartbeat and lower its blood sugar, stunting its growth.

Nebivolol passes into breast milk and can slow and lower the infant's heartbeat and blood sugar respectively, restricting its development. It is recommended that nebivolol should not be used by lactating mothers.

Storage

Nebivolol should be stored in a closed container away from direct sunlight, heat, and moisture. The manufacturer postulates that nebivolol should be stored at room temperature and kept from freezing.

Keep nebivolol out of reach of children to prevent inadvertent ingestion.

Outdated medicine or medicine you are no longer using should be appropriately disposed of. Ask your healthcare provider to facilitate ways to discard any medication properly.

Summary

Nebivolol is an orally administered medicine which is part of the class of medication known as beta-blockers. It is used to treat high blood pressure and heart failure in adults aged 70 years and above. Beta-blockers work by preventing the action of noradrenaline and adrenaline located in the heart that causes the restriction of blood vessels and subsequent increase in the forceful pumping of the heart.

Nebivolol is traditionally administered once a day in the form of oral tablets. The tablets contain 5mg of nebivolol. Adults should take just one pill, once a day, while children should take medicine at the discretion of a medical practitioner.

The proper use of Nebivolol leads to the effective management of high blood pressure. It is crucial to remember that Nebivolol will not cure hypertension, but will help patients manage the medical condition with few side effects.